Advertisement

A Novel Surgical Approach to Nasolabial Fistula

  • Gautham Ullas
  • K. V. VishwasEmail author
  • B. M. Joshna
Original Article
  • 51 Downloads

Abstract

Infection of hair follicle is commonly called ‘boil’ or furunculosis. This can result in abscess formation leading to accumulation of pus and necrotic tissue. This can be more common in immunocompromised patients such as uncontrolled diabetes mellitus. Commonest organism to cause furunculosis is believed to be Staphylococcus aureus. We present an elderly patient where multiple nasal vestibular furunculosis suppurated resulting in extensive tissue damage and nasolabial fistula. Reconstruction was delayed to accommodate tissue healing from hyperglycemic insult and necrosis. Alar advancement flap was employed to give a suitable 3 layer closure to the fistula.

Keywords

Nasolabial fistula Diabetes mellitus Alar advancement Furunculosis nose 

Notes

Funding

This study did not receive any funding or external grant.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest in this study.

Ethical Approval

All procedures performed in this study involving human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the patient included in the study.

References

  1. 1.
    Ibler KS, Kromann CB (2014) Recurrent furunculosis—challenges and management: a review. Clin Cosmet Investig Dermatol. 7:59–64CrossRefGoogle Scholar
  2. 2.
    Pottinger PS (2013) Methicillin—resistant Staphylococcus aureus infection. Med Clin North Am 97:601–619CrossRefGoogle Scholar
  3. 3.
    Price PB (1944) Cause and treatment of furunculosis. JAMA 124(17):1189–1191CrossRefGoogle Scholar
  4. 4.
    Kars M, van Dijk H, Salimans MM, Bartelink AK, van de Wiel A (2005) Association of furunculosis and familial deficiency of mannose-binding lecithin. Eur J Clin Invest 35:531–534CrossRefGoogle Scholar
  5. 5.
    Barie PS, Eachempati SR (2005) Surgical site infections. Surg Clin North Am 85:1115–1135, viii–ixCrossRefGoogle Scholar
  6. 6.
    McAlister FA, Man J, Bistritz L, Amad H, Tandon P (2003) Diabetes and coronary artery bypass surgery: an examination of perioperative glycemic control and outcomes. Diabetes Care 26:1518–1524CrossRefGoogle Scholar
  7. 7.
    Clemens Mark W, Attinger CE (2010) Functional reconstruction of the diabetic foot. Semin Plast Surg 24:43–56CrossRefGoogle Scholar
  8. 8.
    Dahle KW, Sontheimer RD (2012) The Rudolph sign of nasal vestibular furunculosis: questions raised by this common but under-recognized nasal mucocutaneous disorder. Dermatol Online J 18(3):6PubMedGoogle Scholar
  9. 9.
    Veach HO (1940) Aluminium chloride in folliculitis of nose. Cal West Med 52(2):76PubMedPubMedCentralGoogle Scholar
  10. 10.
    Varga J, Pinter S, Antal M, Varga A, Kemeny L et al (2013) Reconstruction of a large upper lip defect with severe associated injuries by the combination of the Kazanjian and Abbé flaps. Surg Curr Res 3:132.  https://doi.org/10.4172/2161-1076.1000132 CrossRefGoogle Scholar
  11. 11.
    Ethunandan M, Macpherson DW, Santhanam V (2007) Karapandzic flap for reconstruction of lip defects. J Oral Maxillofac Surg 65:2512–2517CrossRefGoogle Scholar
  12. 12.
    Baker SN (1995) Local flaps in facial reconstruction. Mosby-Year Books, St. LouisGoogle Scholar
  13. 13.
    Smith PG, Muntz HR, Thawley SE (1982) Local myocutaneous advancement flaps. Alternatives to cross-lip and distant flaps in the reconstruction of ablative lip defects. Arch Otolaryngol 108:714–718CrossRefGoogle Scholar
  14. 14.
    McGregor I, McGregor F (1986) Cancer of the face and mouth. Churchill, EdinburghGoogle Scholar
  15. 15.
    Wang SQ et al (2005) Perialar crescentic flap for lip defects. Dermatol Surg 31(11 Part 1):1445–1447CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Department of Plastic SurgerySandwell and West Birmingham Hospitals NHS TrustWest MidlandsUK
  2. 2.Department of ENT-HNSRajaRajeswari Medical College and HospitalBangaloreIndia

Personalised recommendations